The following background information may present examples of specific aspects of the prior art (e.g., without limitation, approaches, facts, or common wisdom) that, while expected to be helpful to further educate the reader as to additional aspects of the prior art, is not to be construed as limiting the present invention, or any embodiments thereof, to anything stated or implied therein or inferred thereupon. It is believed that spine surgery has become a major field in medicine over the past decades. Because the spine generally provides support and movement for the body, a problem with the spine (e.g., a back disorder) can disrupt even the simplest activities of life. In general, thousands of surgical fusions of the spine are performed each year in an attempt to decrease pain and increase function. Stabilization of the spine may be accomplished in a variety of way including, without limitation, the use of pedicle screws. A pedicle screw is generally a biocompatible screw that is typically inserted into a vertebra at the pedicle, which is a projection from the body of the vertebra that connects the body of the vertebra to the arch of the vertebra. Vertebrae generally have two pedicles.
By way of educational background, an aspect of the prior art generally useful to be aware of is that complications from the use of pedicles screws may occur, which may include, without limitation, loosening of screws, breakage of screws, damage to nearby joints, penetration of major blood vessels, and injuries to delicate neurological structures such as, but not limited to, nerve roots and the spinal cord. Typically, each level of the spine has an associated nerve root which is located just medial and inferior to the pedicle. The nerve root is typically in intimate contact with the pedicle through which the screw passes. If the pedicle screw violates the inferior or medial wall of the pedicle during placement, there may be potential for nerve root injury which may result in pain and/or dysfunction. Patients with nerves that have been damaged by poorly placed pedicle screws may fail to recover and may suffer from chronic and disabling pain. The nerve roots may be injured at the time of surgery, or injury may accumulate over time from the threads of the screws acting against the nerve roots. Due to the potential to damage the nerve roots if the threading of a pedicle screw interacts with the nerve root, proper installation of the pedicle screw is generally a concern in procedures involving pedicle screws.
By way of educational background, another aspect of the prior art generally useful to be aware of is that technology has been introduced over the years in an attempt to decrease the risk of nerve damage associated with placement of pedicle screws. For example, without limitation, one prior art system uses a method of determining the size and trajectory of a pedicle screw through 3D imaging. Also, the use of intraoperative fluoroscopy can reduce the incidence of misplaced screws, as can technology which utilizes computer guidance based on preoperative CT scanning. Even with these technologies, injury to nerve roots may result from the use of pedicle screw fixation.
The facet joints of the spine located between vertebrae are frequently a problem when placing pedicle screws. It is typically desired to preserve the facet joints above a fusion, if possible, during placement of pedicle screws. Injury to the facet joints can lead to chronic pain and the need for additional intervention, including, without limitation, surgery. The relative interaction between facet joints and the heads of implanted pedicle screws varies with the size and shape of these joints, as well as with the relationship of the screw to the entrance point and course of the pedicle. These, and other factors, may make it difficult for the surgeon to know exactly where the head of the pedicle screw will finally rest after insertion.
In view of the foregoing, it is clear that these traditional techniques are not perfect and leave room for more optimal approaches.
Unless otherwise indicated illustrations in the figures are not necessarily drawn to scale.